Key words: Personality, Dysthymia, Alcoholism, Nat mur
Case Presentation
Preliminary Information:
Name: Mr. S.D.S. Age: 35 years yrs. Sex: male
Status: married since 5yrs
Education: 12std
Occupation: Salesman. BPL
Family members: Father: 62yrs Mother: 45yrs Brother: 2 younger. Daughter: 2
CHIEF COMPLAINT
| Location | Sensation | Modalities |
| Mind
Since 2-3 years O: Gradual D: continuous
Since 8 years. Initially occ. Since 2-3 years F: daily; Whisky /country liquor / Beer 180 ml / day |
Sleeplessness +2
Irritability+2 Loss of interest in every thing+2 Brooding on past+2; Continuous movements of lips.+2 App decreased+2 Sex desire decreased +2 No h/o past episode of same
Chronic Alcoholic. Urge to drink alcohol Abstinence for 3 times with Heaviness of head +2 |
A/F:Indignation+2
A/F: Anticipatory anxiety+2 < while thinking+2 < when alone+2
A/F : Indignation+2 A/F: Abstinence of alcohol+ |
Associated complaints:
Skin complaint Rt. foot since 4-5 years O: Gradual.
Scaling eruption +2 White scales Itching +2 No discharge No bleeding. < Evening.
– PHYSICAL FACTORS:
Thermal Cleavage: Hot
Hunger < +2
Dreams: Anxious.
Cravings: fried food+2
Cravings: warm food+2
Motion<+2
FAMILY HISTORY: Fa: BHP; maternal Uncle: Ca; Br: Alcoholic
PAST HISTORY: Gastric ulcer
PATIENT AS A PERSON (LIFE SPACE):
A 35yrs male patient, lean, wheatish complexion, had sad look, seemed very serious at beginning of interview. His speech was slow. He was born in Gujarat, but brought up in Mumbai in a joint family. His family consisted of mother, father, grandfather mother, uncle, aunty and 2 younger brothers.
Father was strict by nature and used to scold patient regarding studies, so he was scared of his father. Mother was caring. Once there was an issue regarding property between patient‘s father and his uncle. At that time patient‘s uncle hurt patient‘s father and expelled him with his family from the house.
Patient was unable to forget this incident as he felt insulted, he had anger towards his uncle. He didn‘t go home for 1 1/2 years. His uncle expired when patient was 7yrs old; at that time he went home. In school he was an average student, he secured good marks up to 8th STD, after that could not focus on study.
He had lots of friends. He started drinking alcohol with a friend. His friend used to tell him to drink alcohol (beer) for enjoyment, to feel he is grown up. He failed in 12th STD and left studies as he was not interested and poor financial status. He started earning by working in a company.
He got married at the age of 30 yrs. He stays in joint family with his brothers. He described himself as introverted person. He was very irritable and gets angry easily, anger is long lasting, don‘t forget any issue and breaks relationship. He often express his anger at his wife. He doesn’t express outside the home because of fear he will have to face consequences and won’t maintain his image.
Three years ago he took a home loan. He was paying his share but his brother was very irregular, hence he used to get tense, disappointed and felt insulted. His mother was ill for 3 months during this time and it was a very stressful period.
From that time patient started drinking alcohol (whisky 180 ml/ day) regularly to relieve stress. He felt as if he has no value and felt humiliated. He seemed to be egoistic and sensitive. Whenever he is angry his eyes and face becomes red. He feels like weeping after anger but won’t cry. He doesn‘t like to talk with people when drunk. His wife is too busy with family and household work and patient feels neglected. Patient works as salesman. Most often there are arguments between him and his boss. He feels insulted, angry, but doesn’t express it, as he gets worries about the consequences he will have to face.
DIAGNOSIS: Dysthymia with chronic psychological alcohol dependency and dry eczema.
Chronic Totality
MIND – AILMENTS FROM – indignation
MIND – AILMENTS FROM – anticipation
MIND – COMPANY – desire for – alone agg.; when
MIND – DWELLS – past disagreeable occurrences, on
GENERALS – RIDING – streetcar; on a – agg.
GENERALS – FOOD and DRINKS – bitter food – desire
GENERALS – SUN – exposure to the sun
Repertorization
Rx: Nat Mur 200 weekly
Follow up:
Over a period of 6 months of treatment mood symptoms like irritability, brooding, loss of interest was improved 70 to 80 % His physiological functions like sleep Appetite and sex were also improved. Skin eruptions were almost resolved, alcohol desire was also bit reduced. Counseling and insight orientation therapy continued to inhibit alcohol drinking
